Perspective: Creating the next generation of general internists: a call for medical education reform.
ABSTRACT The United States is faced with an increasing shortage of physicians in the primary care workforce. The number of medical school graduates selecting careers in primary care internal medicine has fallen dramatically since 1985. Although political, financial, and organizational reform of the medical system is necessary, these changes will address only part of the problem. Endeavors designed to ameliorate this current crisis in primary care practice must also address the education and training of future primary care internists. Learners require specialized training in primary care internal medicine to be able to provide high-quality, patient-centered, outcome-oriented care. This article examines the impact of educational interventions in undergraduate medical education (UME) and graduate medical education (GME) on primary care internal medicine career choice and makes suggestions for future educational changes. Suggested UME changes include providing early longitudinal clinical experiences and providing the option for an integrated ambulatory third year of training. Suggested GME changes include early, sustained exposure to general internal medicine and differentiated training tracks for residents interested in primary care. Key among these changes are that medical students and residents must have adequate mentorship from primary care internists and clinical experiences in highly functioning primary care settings established as patient-centered medical homes. Academic centers have a unique opportunity to contribute to these imperatives by reengineering the practice of primary care in a way that embodies the core values of effective, patient-centered care.
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ABSTRACT: During their studies to become medical professionals, all students are obliged to become familiar with various aspects of primary care. The aim is to provide all students with a high quality training which ensures the best possible cooperation across all sectors of the medical system. Primary care comprises the primary use of the medical service by an unfiltered set of patients as well as continued patient care - including home-care. This position paper was developed together with representatives of the German Society of University Teachers of General Practice (GHA), the German Society for Ambulatory General Paediatrics (DGAAP), the German Society of General Practice and Family Medicine (DEGAM) and the German Society for Internal Medicine (DGIM). It includes recommendations for teaching in the field of primary care in four different types of internships such as preclinical work experience ("Hospitation"), 4-week clinical traineeships of a casual nature ("Famulatur") and 2-week courses of structured and assessed clinical training ("Blockpraktikum") as well as a broad-based 4-month elective clinical placement in the final year (known as a practical year, "PJ"). The recommendations encompass structural and process criteria for internships in different general practices. In addition, for the first time recommendations for teaching on campus - in the fields of general medicine, paediatrics, numerous cross-sectional areas and other clinical fields, but also for clinical skills training - are set down here. In this position paper the intention is to demonstrate the possible ways in which more aspects of primary care could be integrated into undergraduate medical training.GMS Zeitschrift für medizinische Ausbildung. 01/2014; 31(3):Doc35.
- Revista medica de Chile 05/2012; 140(5):609-615. · 0.37 Impact Factor
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ABSTRACT: Background: Medical students are the future doctors in any country. The lack or surplus of medical school interest in specialties influences and affects the health services in a country. Objective: In our study we evaluated the interest of medical students in Internal Medicine at a University in Sudan. Methods: A cross-sectional study was conducted in September 2013 at Faculty of Medicine, University of Medical Sciences and Technology (UMST), Khartoum, Sudan. A self-administered questionnaire was given to 887 male and female students enrolled at UMST. Results: A total of 887 questionnaires were handed out, of these 647 questionnaires were returned (response rate of 73%). Of the returned questionnaires 604 were valid and considered. Table 1 shows the general characteristics of the valid responses. The majority of our respondents were females 371 (61.4%) and 233 students were males (38.6%). There were 142 students interested in internal medicine. Of them, 95(21.3%) were in pre-clinical years, 47(29.6%) clinical, 25.3% were male and 22.4% were female. Amongst the subspecialties within medicine, 33.1% of students chose Cardiology as their first choice subspecialty, followed by Internal Medicine (26.8%), Neurology (13.4%) and Dermatology (11.3%). Conclusion: Medicine is second most popular specialty selected by medical students. The highest selected sub-specialty was cardiology. The main reasons for selecting Medicine as a career is personal interest, followed by being helpful to the community, and lastly job opportunities.International Journal of Health. 06/2014; 2(2).